Diffuse panbronchiolitis: report of a case

A 33-year-old male presented with a productive cough of yellowish sputum which he had had for several years and progressive dyspnea on exertion that had been present for one year. Physical examination on admission disclosed clubbing of the fingers, diffuse inspiratory crackles and some rhonchi on auscultation. Plain chest film showed diffuse fine nodular lesions in both lungs. Pulmonary function tests demonstrated obstructive ventilatory impairment with a positive bronchodilator response. A CT scan of the chest showed diffuse fine nodular infiltrations in both lung fields. Arterial blood gas analysis of the patient, while breathing room air, revealed mild hypoxemia. The histologic findings of an open lung biopsy specimen were compatible with a diagnosis of diffuse panbronchiolitis. The patient was treated with erythromycin and a bronchodilator, and was regularly followed at the outpatient department. In this report, clinical manifestations, diagnostic criteria and recent advances in the treatment of diffuse panbronchiolitis are discussed.

Shoulder computed arthrotomography: role of internal and external rotation

Computed arthrotomography of the shoulder is the best investigation for instability of the glenohumeral joint. The purpose of this paper is to evaluate the role of internal rotation and external rotation in detecting glenoid and capsular lesions. From October 1989 to December 1991, 74 double-contrast CT arthrograms of the shoulder were performed with both internal and external rotation. Most of these patients were referred for instability problems or shoulder pain of vague origin. Of the 49 abnormalities of the anterior portion of glenoid labrum, 44 (89.8%) were identified on the scans with internal rotation; however, 5 (10.2%) was seen only in external rotation view. Most of the anterior capsular abnormalities occurred on the internal rotation. Only one of 74 examination was evidenced solely on external rotation. There were relatively few posterior labral or capsule abnormalities. Of the five, two were seen solely on external rotation. The results suggest that internal rotation scans detect most of the lesions; however, with the help of external rotation view, 10% increase in diagnostic yield can be expected for anterior labral abnormalities. Although few posterior labral or capsule lesions occur, external rotation examination does play an important role in this respect.

Magnetic resonance image of internal derangement of the temporomandibular joint

Sixteen temporomandibular joints (TMJ) were examined by a high resolution magnetic resonance (MR) imager. Multisection 3.5 mm thick sagittal and coronal images were obtained by 1.0-T MR system and spin-echo sequence (TR = 800 msec, TE = 20 msec). MR provided useful information about meniscal position, morphology and histology. In our study, the MR of the 16 TMJ showed normal finding in two cases and abnormal findings could be differentiated into anterior disc displacement with reduction (8 cases), anterior disc displacement without reduction (3 cases) and bony change (3 cases). MR imaging can produce high-quality tomographic images with good demonstration of the internal structures of TMJ. As it is a noninvasive technique involving no ionizing radiation, MR imaging has been shown to be a useful tool for the demonstration of internal changes in TMJ.

Differential expression of Hz-1 baculovirus genes during productive and persistent viral infections

Hz-1 viral RNA transcription was studied during productive and persistent infections. The RNAs were localized to 10- to 30-kb regions within the viral genome, and the timing of their expression was determined. During productive infections, we detected 101 virus-specific transcripts that could be grouped into three categories by time of appearance. At 2 h postinoculation (p.i.), a total of 34 virus-specific transcripts were detected. An additional 51 and 16 virus-specific transcripts appeared between 4 and 6 h p.i. and at 8 h p.i., respectively. After 8 h, no new transcripts were found. Under conditions of persistent infection, we detected only one viral persistency-associated transcript (PAT1). The region of the viral DNA which encodes PAT1 was cloned. During productive infections, three transcripts were derived from this region. Each had the same polarity as PAT1. One of them was of the same size as PAT1 and had similar, if not identical, 3' and 5' ends. This report provides detailed and very useful information concerning sequentially expressed transcripts of the Hz-1 baculovirus.

Cystic spinal neurilemmoma on magnetic resonance imaging

We report a complete cystic change of intradural neurilemmoma at the T12-L1 level. T1-weighted MRI images with gadolinium-DTPA clearly enhanced the thin capsule of the cystic tumour.

Fluid levels in aneurysmal bone cysts

Aneurysmal bone cysts are benign, expansile, osteolytic lesions of the bone. All the aneurysmal bone cysts studied in this case report were observed during the 2 year period, 1989 to 1991. The patients involved had received radiographic examination: plain and magnetic resonance (MR) image; one of the patients also received a computed tomography (CT). The plain radiograph generally showed a well-defined, expansile, osteolytic lesion associated with a pathologic fracture; the CT and MR images showed a fluid-fluid level within the lesion. This paper will report the findings of fluid-fluid levels, using radiographic images, in aneurysmal bone cysts.

Traumatic sinus of Valsalva fistula

Two rare cases of nonpenetrating trauma-induced fistula from the right sinus of Valsalva to the right heart chambers are reported. Both were diagnosed preoperatively and operated on successfully. A transverse tear was found in the right sinus of Valsalva, just below the right coronary ostium, in both patients. The ragged inlet and a rough fistula tract were noted during operation. The tears were closed with direct sutures or with a Dacron patch. Coronary artery bypass grafting was needed in 1 patient. The results of operation were excellent.

Organization and stability of a polytopic membrane protein: deletion analysis of the lactose permease of Escherichia coli

The overall topology of polytopic membrane proteins is thought to result from either the oriented insertion of the N-terminal alpha-helical domain followed by passive insertion of subsequent helices or from the function of independent topogenic determinants dispersed throughout the molecules. By using the lactose permease of Escherichia coli, a well-characterized membrane protein with 12 transmembrane domains and the N and C termini on the cytoplasmic surface of the membrane, we have studied the insertion and stability of in-frame deletion mutants. So long as the first N-terminal and the last four C-terminal putative alpha-helical domains are retained, stable polypeptides are inserted into the membrane, even when an odd number of helical domains is deleted. Moreover, even when an odd number of helices is deleted, the C terminus remains on the cytoplasmic surface of the membrane, as judged by lacY-phoA fusion analysis. In addition, permease molecules devoid of even or odd numbers of putative transmembrane helices retain a specific pathway for downhill lactose translocation. The findings imply that relatively short C-terminal domains of the permease contain topological information sufficient for insertion in the native orientation regardless of the orientation of the N terminus.

Characterization of Alu repeats surrounding the human ferredoxin-encoding gene

Three Alu sequences have been identified surrounding the human ferredoxin-encoding genes. Among them, one is located about 1000 bp upstream from the active gene, whereas two others flank the ferredoxin pseudogene, psi FDX3. All these Alu sequences contain poly(A) tails and are flanked by direct repeats, indicating that they arose by RNA-mediated transposition events.

Evolution of Alu repeats surrounding the human ferredoxin gene

Ferredoxin is an iron-sulfur protein that serves as an electron carrier for the mitochondrial oxidation/reduction system. During the characterization of the human ferredoxin gene, we have identified three Alu sequences surrounding it. When these Alu sequences were compared with others, all three of them are more related to the consensus Alu than the 7SL gene, the progenitor of the Alu family. It suggests that they are members of the modern Alu family. Their sequences differ from the Alu consensus sequence by about 5%, indicating that they were inserted into the chromosome about 35 million years ago.

[MRI of white matter pathways]

CT scan shows some relatively large white matter pathways such as corpus callosum or internal capsule, while MRI provides more sophisticated display of cerebral white matter pathways, based partly on difference in the water content, which improves contrast resolution of structures that cannot be appreciated on CT scanning. The white matter shows slightly high signal intensity in T1WI as compared with the peripheral gray matter. In contrast, it is relatively low signal intensity in long TR sequence. The signal intensity is correlated with myelination, density of myelin fibers and possibly iron deposition. In this study, we collected data on 30 patient, aged from 3 to 60 years average 38 years of normal MRI study of the brain. We routinely obtained T1 Weighted image (T1WI, TR/TE 500-600/20 msec), dual echoes image of proton density image (PDI, TR/TE 2000-3000/20 msec), T2 weighted image (T2WI, TR/TE 2000-3000/80-120 msec), in axial and coronal sections. In some cases sagittal section was also imaged. We identified the white matter pathways based on the data from the axial and coronal sections of 2 autopsy specimens. We also consulted several textbooks and literature reviews of gross and MRI anatomy. The following white matter pathways could be clearly observed on MRI: 1. Projection fibers: corona radiata and internal capsule; 2. Commissural fibers: corpus callosum and anterior commissure; 3. Associated fibers: superior occipito-frontal fasciculus, superior longitudinal fasciculus, ucinate fasciculus, cingulum bundle, optic radiation fornix and mammillothalamic tract.

Granulosa cell tumor of the ovary

In the past 20 years, approximately half of the 25 women with granulosa cell tumor of the ovary studied, were dead. The results showed that recurrence or metastasis had a statistically significant correlation with survival. The other factors, such as the patients' age, the content of the tumor, ascites, endometrial change, mitosis and rupture, have no relationship with the survival rate in our study.

The lethal lambda S gene encodes its own inhibitor

The 107 codon reading frame of the lambda lysis gene S begins with the codon sequence Met1-Lys2-Met3..., and it has been demonstrated in vitro that both Met codons are used for translational starts. Furthermore, the partition of initiation events at the two start codons strongly affects the scheduling of lysis. We have presented a model in which the longer product, S107, acts as an inhibitor of the shorter product, S105, the lethal lysis effector, despite the fact that the two molecules differ only in the Met-Lys residues at the amino terminus of S107. Using immunological and biochemical methods, we show in this report that the two predicted protein products, S105 and S107, are detectable in vivo as stable, membrane-bound molecules. We show that S107 acts as an inhibitor in trans, and that its inhibitory function is entirely defined by the positively charged Lys2 residue. Moreover, our data show that energy poisons abolish the inhibitory function of S107 and simultaneously convert S107 into a lysis effector. We propose a two step model for the lethal action of gene S: first, induction of the S gene results in the accumulation of S105 and S107 molecules in mixed oligomeric patches in the cytoplasmic membrane; second, S monomers rearrange by lateral diffusion within the patch to form an aqueous pore. The R gene product, a transglycosylase, is released through the pore to the periplasm, resulting in destruction of the peptidoglycan and bursting of the cell. According to this model, the lateral diffusion step is inhibited by the energized state of the membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

Structure, sequence, chromosomal location, and evolution of the human ferredoxin gene family

Ferredoxin is an iron-sulfur protein that serves as an electron transport intermediate for mitochondrial cytochromes P450 involved in steroid, vitamin D, and bile acid metabolism. We cloned and characterized the human ferredoxin gene family, which includes two expressed genes and two pseudogenes. Sequence analysis of this gene family revealed that it encodes only one protein product. The expressed genes were assigned to chromosome 11 and pseudogenes to chromosomes 20 and 21 by identifying single-copy probes from each gene segment and hybridizing them to DNA from rodent-human hybrid cells. The pseudogenes lacked introns and contained numerous mutations, including insertion, deletion, and substitution which rendered them inactive. They were 96% and 85% homologous to the expressed gene, yet they were only 78% homologous with each other. The intronless nature, higher diversity among themselves, and distinct chromosomal location of the pseudogenes suggests that they arose by independent, retroposon-mediated events.

[The relationship of clinical severity and roentgenologic findings in beta thalassemia]

There were altogether 68 patients suffered from beta-thalassemia in the Veterans General Hospital from 1979 to 1986. However only 18 patients had abnormal roentgenologic findings. They were 7 males and 11 females. Their ages ranged from 8 months to 47 years with an average of 13 years. Clinically beta-thalassemia was divided into 3 types: 1) thalassemia major, 2) thalassemia intermediate, 3) thalassemia minor. The osteoporosis, hepatosplenomegaly, and extramedullary hematopoiesis with pseudo-tumor formation. We concluded that the roentgenologic manifestation of the patient was more in patients with major or intermediate type.

CT evaluation of polymorphic reticulosis

For the understanding of the CT findings of polymorphic reticulosis involving the upper respiratory tract, we reviewed eleven cases of this disease with initial CT study before treatment. CT revealed masses or swelling in the nose or nasal chamber, often with involvement of paranasal sinuses and medial parts of the orbit. In some, nonspecific minimal bony change (either bone destruction or bone sclerosis) was found. These CT findings are not specific. Any large mass in the nose and nasal fossa with little associated bone destruction should, however, raise the differential diagnosis of polymorphic reticulosis.

Temporary complementation of temperature-sensitive mutants of the cell cycle by transfection with a wild-type or a mutant cDNA of ADP/ATP translocase

A number of cell-cycle-specific temperature-sensitive (ts) mutants have been isolated from animal cells, especially Syrian hamster cells. These ts mutants, like cell cycle ts mutants of yeast, can be complemented by specific genes, some of which have been molecularly cloned. We have isolated a cDNA clone that complements TK-ts13 cells, but only temporarily. This clone, called B1, differs from a previously isolated clone (Sekiguchi et al.: EMBO Journal 7:1683-1687, 1988) that specifically complements ts13 cells. In addition, B1 also complemented temporarily three other ts mutants of the cell cycle, tsAF8, ts694, and ts550C cells. These mutants have different mutations since, in cell fusion experiments, they complement each other. Sequencing of the B1 cDNA clone revealed that it was a mutant of human ADP/ATP translocase in which some human sequences at the 5' end have been replaced by SV40 sequences. The wild-type translocase was less effective but could still increase the survival time of cell cycle ts mutants at the restrictive temperature. Using the polymerase chain reaction, it was possible to demonstrate that the B1 plasmid is expressed in TK-ts13 cells undergoing temporary complementation.

Maternal serum alpha-fetoprotein screening in Taiwanese women

From January 1986 to August 1988, a maternal serum alpha-fetoprotein (MSAFP) screening program was performed at Mackay Memorial Hospital. Clinical Assay Gamma Dab [I125] AFP RIA Kit (Baxter U.S.A.) was used for the quantitative measurement of AFP in maternal serum. Between 16 and 25 gestational weeks, MSAFP above the cut-off value at 2.5 multiples of the median was able to detect 5/7 cases of anencephalus, 2/4 cases of encephalocele, 3/3, cases of omphalocele, 11/40 cases of twin pregnancies. Among 10 cases with autosomal trisomies, 8/10 were less than 0.6 multiples of the median and 4/10 were less than 0.4 multiples of the median.

Syndrome of intermetamorphosis: a new perspective

Capgras syndrome is an often reported misidentification syndrome. In contrast, the syndrome of intermetamorphosis has been rarely reported. We describe three new cases of the syndrome of intermetamorphosis and propose a new nomenclature that may further systematic study of misidentification syndromes.

Hyperparathyroidism presenting as a large bone tumour. A case report

A 59-year-old man, who presented to hospital with a large expansile bone tumour over the left elbow and a mass in the right side of the neck, was eventually found to have parathyroid adenoma manifesting clinically as severe hypercalcaemia. Histological examination of a section of the neck mass showed parathyroid adenoma and the bone biopsy specimen revealed a 'brown tumour', consistent with hyperparathyroid bone disease.

Routine pretreatment evaluation in cervical carcinoma

A review of 573 previously untreated patients with invasive cervical carcinoma was undertaken to determine the significance of the routine pretreatment performance of chest x-ray, intravenous pyelography (IVP), cystoscopy and sigmoidoscopy. Chest x-ray was performed in 570 patients (99.5%), IVP in 514 (89.7%), cystoscopy, 502 (87.6%) and sigmoidoscopy, 496 (86.6%). The overall yield of tumor-related abnormalities demonstrated in chest x-ray, IVP, cystoscopy and sigmoidoscopy was 1.8%, 9.1%. 6.4% and 1.2% respectively. The chest x-ray findings changed the initial clinical stage in 1.3% of cases, IVP in 4.2%, cystoscopy in 4.0% and sigmoidoscopy in 0.6%. There were 5 instances of bladder involvement and 5 of bullous edema of the bladder found in patients originally classified as having stage I or stage II disease. Thus, to omit cystoscopy may not be so safe in patients with stage I and stage II diseases. We suggest that chest x-ray, IVP and cystoscopy should be performed as part of staging in all patients with cervical carcinoma, however, sigmoidoscopy can be reserved for those initially diagnosed to have advanced disease or symptomatic patients.

CT and myelogram findings of os odontoideum

We reviewed the findings of CT and myelogram of cases of os odontoideum. The diagnosis was confirmed by conventional tomogram in all these cases. Four cases were further confirmed by trans-oral decompression. Cartilage was found between the os odontoideum and the odontoid process during operation in these 4 cases. Four of them had no history of trauma and 2 of them had an associated anomaly; one was Down's syndrome, and the other was barrel chest and congenital dislocation of hips. CT findings of os odontoideum in these cases were a constriction and/or a gap of bony structure between the os odontoideum and the odontoid process. Myelograms showed spinal stenosis as a result of atlanto-axial dislocation, or anterior extradural compression from overgrown cartilage and posteriorly dislocated tip of shortened odontoid process.

Analysis of the human adrenodoxin promoter: evidence for its activity

Adrenodoxin is an iron-sulfur protein serving as an electron transfer intermediate in the mitochondrial cytochrome P450 system. To study its transcriptional regulation we construct a human adrenodoxin genomic clone which includes 333 bp of DNA upstream of the mRNA start site. This DNA contains a TATA box and two GC boxes. When we place it in front of the CAT reporter gene and transfect it into the recipient cell lines, it directs transcription of the CAT gene. This DNA in reverse orientation does not show any transcriptional activity. This promoter element functions in three mammalian cell lines: JEG-3, COS-1, and Y-1.

Cloning and structure of the human adrenodoxin gene

Adrenodoxin is an iron-sulfur protein that serves as an electron transport intermediate for all mitochondrial forms of cytochrome P450. To facilitate studying the regulation of adrenodoxin, we have cloned and determined the structure of the human adrenodoxin gene. It spans more than 20 kb, containing four exons and three introns. The first exon encodes the 60-amino-acid signal peptide, directing transport of the protein into the inner mitochondrial matrix. The mature peptide of 124 amino acids is encoded by the other three exons. The third exon encodes the portion of the protein containing the iron-sulfur center and a domain which binds other components of the electron transport chain. The transcriptional start sites were determined by primer extension and S1 nuclease mapping. The 5'-flanking region of this gene contains canonical promoters including a TATA box at nucleotide position -30 and two GC boxes at nucleotide positions -60 and -100. The sequence at nucleotides -234 to -252 is also highly homologous to the glucocorticoid-responsive element and the estrogen-responsive element.

Assignment of the functional gene for human adrenodoxin to chromosome 11q13----qter and of adrenodoxin pseudogenes to chromosome 20cen----q13.1

Adrenodoxin is a small iron/sulfur protein serving as an electron-transport intermediate for all mitochondrial forms of cytochrome P450. Southern blots of normal genomic DNA cleaved with six restriction endonucleases probed with full-length human adrenodoxin cDNA revealed complex patterns indicating the presence of multiple adrenodoxin genes. Southern blots of DNA from a panel of mouse/human somatic cell hybrids identified cross-hybridizing adrenodoxin DNA in two loci, chromosome 11q13----qter and chromosome 20cen----q13.1. Examination of adrenodoxin clones from a genomic DNA library in phage lambda revealed some clones bearing gene fragments interrupted by introns and other clones bearing processed pseudogenes. By probing the mouse/human hybrids with unique intronic DNA and by correlating restriction maps of the phage clones with that of uncloned genomic DNA, we show that the authentic transcribed adrenodoxin gene lies on chromosome 11, while pseudogenes lie on chromosome 20.

Computed tomography of a meniscal cyst

A meniscal cyst of the knee is a rare lesion, and a palpable large meniscal cyst is even more rare. This article suggests that CT scan demonstrates clear location, size, contents, and connection of the cyst with meniscus and peripheral tissue. By a combination of arthrography and CT scan, detection of the cysts in zone 3 (parameniscal area) is possible with ample demonstration of whether the cyst is associated with a meniscal tear. This provides a guideline in determining the treatment of the lesion.

Marrow culture studies in adult acute myeloid leukemia at diagnosis and during complete remission

We used the human placental conditioned medium stimulated single layer agar culture technique to study the in vitro growth of marrow cells from 62 adult patients with acute myeloid leukemia (AML). Bone marrow cells were cultured from 50 patients at the time of initial diagnosis, 19 patients in early remission and 20 patients during their full complete remission. Marrow cultures from untreated patients exhibited heterogeneous growth patterns ranging from complete growth failure to excessive microcluster formation. We classified the growth patterns into 4 groups: (1) Gr I: normal growth, (2) Gr II: no growth, (3) Gr III: decreased growth, (4) Gr IV: excessive growth of microclusters. At presentation, none had Gr I growth; Gr II growth was observed in 23; Gr III in 14 and Gr IV in 13. A predominance of no growth were seen in M1 and M3 subtypes, while Gr IV growth was more commonly observed in M2 or M4 subtype. We were unable to correlate the culture findings with age or white cell count. The present results not only indicated that AML at diagnosis was characterized by abnormal granulopoiesis but also demonstrated that leukemic progenitor cells were heterogeneous with different capacities to express their proliferating potential in vitro. Except few with decreased growth, the growth characteristics generally returned to normal with successful remission induction. Both Gr II and Gr IV growth patterns were not observed either in early remission or during full complete remission.

Testicular gonadal stromal (Sertoli cell) tumor

Eighty-one cases of testicular gonadal stromal tumor have been reported in the literature. An additional case is herein reported. The pathologic, immunohistologic, and histogenetic aspects are presented.